Clin Psychopharmacol Neurosci.
2021 May;19(2):190-205. 10.9758/cpn.2021.19.2.190.
Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder According to the Existing Psychiatric Comorbidity
- Chou PH
1,2,3,4 - Lin YF4,5,6,7
- Lu MK8,9
- Chang HA10
- Chu CS11,12,13
- Chang WH14,15
- Kishimoto T16
- Sack AT17,18
- Su KP2,19,20,21
- Affiliations
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- 1Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
- 2Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan
- 3Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
- 4Taiwan Allied Clinics for Integrative TMS, Taipei, Taiwan
- 5Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
- 6Department of Public Health & Medical Humanities, Faculty of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- 7Balance Psychiatric Clinic, Hsinchu, Taiwan
- 8Ph.D. Program for Translational Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- 9Department of Neurology, China Medical University Hospital, Taichung, Taiwan
- 10Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- 11Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- 12Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- 13Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- 14Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 15Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
- 16Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- 17Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University,
- 18Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain＋Nerve Centre, Maastricht University Medical Centre＋ (MUMC ＋), Maastricht, The Netherlands
- 19College of Medicine, China Medical University, Taichung, Taiwan
- 20Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
- 21An-Nan Hospital, China Medical University, Tainan, Taiwan
- KMID: 2516172
- DOI: http://doi.org/10.9758/cpn.2021.19.2.190
Abstract
- Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) are evidenced-based treatments for patients with major depressive disorder (MDD) who fail to respond to standard first-line therapies. However, although various TMS protocols have been proven to be clinically effective, the response rate varies across clinical applications due to the heterogeneity of real-world psychiatric comorbidities, such as generalized anxiety disorder, posttraumatic stress disorder, panic disorder, or substance use disorder, which are often observed in patients with MDD. Therefore, individualized treatment approaches are important to increase treatment response by assigning a given patient to the most optimal TMS treatment protocol based on his or her individual profile. This literature review summarizes different rTMS or TBS protocols that have been applied in researches investigating MDD patients with certain psychiatric comorbidities and discusses biomarkers that may be used to predict rTMS treatment response. Furthermore, we highlight the need for the validation of neuroimaging and electrophysiological biomarkers associated with rTMS treatment responses. Finally, we discuss on which directions future efforts should focus for developing the personalization of the treatment of depression with rTMS or iTBS.
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